Background: Fracture of the penis is a urological emergency which occurs as a result of abrupt trauma to an erect penis. Immediate surgical repair is the standard of care and is superior to non- operative management due to excellent long term outcomes. Objective: The aim of this study was to investigate surgical and functional outcomes in patients who underwent penile fracture repair. Methods: A cross sectional descriptive study was conducted during the period of July 2017-June 2018 to find out the pattern of surgical management of fracture penis among the patients admitted in the urology department of Dhaka Medical College Hospital. A total 50 patients of fracture patients were selected purposively. Outcome of surgical management was investigated by using semi structured and International Index of erectile function questionnaire. Results: The study reveals that the mean age of the patients were 34.26±9.96 (range: 18–65), predominantly married (70%). The mean follow-up period was 12 weeks. Patients ‘history and clinical examination were highly sensitive and accurate in predicting a tunical tear. 15 patients (30%) received surgical treatment within six hours from the hospital admission, while 31 patients and 4 others seek surgical intervention within 6-24 hours and more than 24 hours respectively. It was revealed that the presenting symptoms were pain (72%), penile swelling (100%), eggplant deformity (100%), and hematuria (22%) with associated urethral injury in 22% of patients. Post- operative complications found were infection (14%), penile nodule (26%), chordee (14%), painful erection (16%) and erectile dysfunction (34%). There is a significant relationship between having painful erection and erectile function of the patients at the time of interview [X²=23.44, df=4, p=0.000], The relationship between the time elapsed from hospital admission to surgery and erectile function at the time of interview was not significant [X²=10.39, df=8, p=0.239]. The relationship ..
Background: On patient quality of life, stent-associated symptoms can have a significant impact. Related to indwelling ureteral stents, hematuria, urgency, frequency, dysuria, and both bladder and flank pain are the most prevalent symptoms. Among them low back pain and irritative lower urinary tract symptoms and are more frequent. Because of its importance stent is being kept in situ with varieties of medication despite the stent related symptoms. To relief these symptoms like Tamsulosin, Solifenacin, Alphazosin etc., several alpha-adrenergic blocker and antimuscarinic drugs are used. Tamsulosin and Solifenacin both are not costly as use daily single dose. So combination of Tamsulosin and Solifenacin cost effective and may act as a reliever of stent related symptoms also. Objectives:To evaluate the effect of Tamsulosin and Solifenacin in relieving DJ stent related symptoms. Methodology:This prospective quassi experimental study was performed from November 2016 to April 2018. Patients who placed DJ stent after endoscopic stone management in the Department of Urology, Dhaka Medical College and Hospital recruited as study population. A total of 47 patients who were stented following ureteroscopic lithotripsy were included, allocated purposively into two groups. Group A (Tamsulosin) 24 and and Group B (Solifenacin) 23 patients were selected by purposive sampling technique according to inclusion and exclusion criteria for the study.
A 45 years old male, nondiabetic, hypertensive, nonasthmatic, nonsmoker, farmer from Pabna presented with the complaints of pain over right hypochondrium for 4 months andalso gave history of significant weight loss of about 15 kg in the last 6 months. He also developed bilateral gynecomastia for 2 years.On examination, Blood pressure was 200/100 mm of Hg and bilateral gynecomastia were present.Both testes were mildly atrophied.Systemicexamination revealed mild tenderness in right hypochondrium on deep palpation of abdomen.USG of W/A revealed A heterogenous mixed echogenic mass (9.9*8.9) was seen in upper polar region of right kidney. Suggestive of Right suprarenal mass. CT scan W/A with contrast showed heterogenous contrast enhancing well defined rounded soft tissue density lesion measuring about 90*86 mm was noted in right adrenal region which revealed a right adrenal mass consistent with adrenal pheochromocytoma. However,clinical biochemistry tests revealed normal levels of plasma catecholamines (dopamine,norepinephrine, and epinephrine) and metanephrine, which are unusual findings in adrenal pheochromocytoma.Serum Aldosterone,Basal cortisol, Renin in plasma, ACTH and 24 hours Urinary Free cortisol were normal.Meanwhile, The patient had persistent hypokalemia and serum Testosterone, LH and FSH were below normal level. Open right adrenalectomy was done. Histopathology and immunohistochemistryconfirmed the diagnosis of adrenal pheochromocytoma. Following surgery, the patient did well and showed full recovery at follow-up after one month. To our knowledge, this is the first report in Dhaka Medical college hospital of the extremely rare entity of pheochromocytoma with an unusual clinical and biochemical scenario. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.168-171
Background: Prostate cancer is common in urological practice. Diagnosis of prostate cancer depends on biopsy of the prostate. For the last two decade TRUS guided 6 core (sextant) biopsy is being considered as standard for prostate biopsy. Various studies in different countries showed the drawback of sextant biopsy. The debate remains alive on number of biopsy core which is appropriate for obtaining representative tissue. Moreover, more number of needle biopsy may be associated with more complication. Methods: In this hospital based Quasi experimental study, a total of 50 patients were allocated into two groups by purposive sampling technique where 6 core prostate biopsy in one group and 12 core biopsy in another group. Baseline demographic and clinical data were recorded. Post procedural morbidity & histopathological findings were recorded. All the collected data were compiled. Further Statistical analyses of the results were obtained by using Microsoft Xcel, 2010 and web based computer software - Graph Pad Software, 2017. A probability value (p) of less than 0.05 was considered to indicate statistical significance. Results: The baseline characteristics like age, S.PSA, prostate volume & DRE findings were similar in two groups. Cancer detection rate was not significantly different between the 6 core biopsy group and 12 core biopsy group (48% Vs 60%, p=0.395). Dysuria with difficulty in micturition and hematuria after biopsy significantly more in 12 core biopsy group (24% Vs 44% and 32% Vs 60% respectively). Other post procedural complications like fever, perrectal bleeding was found statistically not significant between two groups Conclusion: Trans rectal ultrasound guided 6 core biopsy is equally effective as Trans rectal ultrasound guided 12 core biopsy for detection of prostate cancer.
Background: The management of VVF involves a multi-modal technique. Surgical repair remains the treatment of choice for VVF. The repair could be undertaken through the transabdominal or transvaginal route. Although the vaginal route was the commonest route employed in the repair of VVF, it is clearly associated with post-operative incontinence, high recurrence and low success rate. Objectives: To compare the outcomes of surgical repair of vesicovaginal fistula between transabdominal and transvaginal Route. Methods: This prospective comparative study intended to compare the outcomes between surgical repair of vesicovaginal fistula- between transabdominal and transvaginal route. A total of 50 cases of VVF patient planned for surgical repair of VVF in Dhaka Medical College Hospital from April 2017 to September 2018, included in this study according to the inclusion and exclusion criteria. Cases were randomly allocated to group A (Transabdominal repair of VVF) and group B (Transvaginal repair of VVF). Each group consisted of 25 patients. The outcome variables were success rate of operation, post-operative complication, post-operative pain, post-operative hospital stay and recurrence. Data were analyzed and compared by statistical tests. Results: No significant differences were found regarding age (p=0.3921), etiology (p=1.000), fistula number (p=0.4174), haematuria (p=0.667), vaginal bleeding (p=1.000), wound infection (p=0.4174) and hospital stay (p=0.4828) between two groups. Post-operative incontinence (p<0.0448) was less in group A than group B cases. Success rate is higher in group A in comparison to group B (p<0.0223). Conclusions: Trans-abdominal route is better than trans-vaginal route in VVF repair. It significantly reduces post-operative incontinence and recurrence of VVF. Success rate is also high in trans-abdominal route than trans-vaginal route. So, VVF repair by trans-abdominal route is safe and effective.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.